Fábregas: Biden's effort may be one small step for curing cancer, but it's worth a 'moon shot'

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He's not running for president, so Vice President Joe Biden will spend the rest of his term carrying out a “moon shot” to cure cancer.

That much we heard from the Obama administration, which announced that Biden will be in charge of “mission control” in this effort. Biden's son, Beau, died in May from complications of brain cancer at age 46.

“For the loved ones we've all lost, for the family we can still save, let's make America the country that cures cancer once and for all,” President Obama said in last week's State of the Union speech.

Easier said than done.

Cancer isn't just one disease, so it's not like researchers will come up with a one-size-fits-all cure. There are more than 100 types of cancer. Some are linked to our genetic makeup; others are linked to factors such as smoking or sun exposure.

“No single thing is going to make the difference in cancer,” said cancer expert Dr. Nancy Davidson, director of the University of Pittsburgh Cancer Institute and a noted breast cancer researcher.

Cancer has been on the government's radar since 1971, when President Nixon declared a “war on cancer,” saying it was time for America to give cancer “the same kind of concentrated effort that split the atom and took man to the moon.”

Though much progress has been made since, and cancer deaths are down during the past 20 years, cancer continues to confound medicine. There will be nearly 1.7 million new cancer cases this year, according to the American Cancer Society.

Doctors haven't figured out why pancreatic and ovarian cancers are so hard to catch before they spread. They've stumbled in trying to minimize unpleasant side effects people get from therapies, and in trying to maximize the lives of survivors so they're not further burdened by cancer.

All the while, experts argue the benefits and harms of early screenings for prostate, breast and other cancers.

In some parts of the United States, cancer is a bigger killer than heart disease, the leading global cause of death. And then there's the issue of cost — some cancer drugs save lives but can cost as much as $100,000 a year per patient, according to a paper published last year in the Mayo Clinic Proceedings.

“We cancer people aren't quite as successful as we'd like to be,” Davidson said. As president-elect of the American Association for Cancer Research, she had heard chatter about Biden's plan, which she said puts cancer research on a “promising path.”

That path includes looking at DNA in our bloodstream. Because cancer cells often die and spill into the blood, the thought is that new molecular techniques can be used to test the blood and give doctors a snapshot of abnormalities in cells.

That could help them figure out which tumors respond to which therapies. It could lead doctors to diagnose a recurrence early and determine whether a patient who has surgery, for example, would benefit from additional therapy after the operation.

“People are very interested in whether or not you can use the circulating free DNA to monitor the burden of the metastatic cancer, to see if it's getting better or worse with therapy, and also to see whether different kinds of molecular changes evolve over time as the cancer progresses or regresses,” Davidson said.

The race against cancer is so fierce, a San Diego-based company said last week it is developing a blood test to screen for cancers even before symptoms develop. The company, Illumina, has big investors in its corner, including philanthropist Bill Gates and Amazon founder Jeff Bezos.

Davidson said this research is important, but this type of test is “far from any kind of human practice.”

“When I order a test, the patient and I need to understand that I'm ordering a test because it's going to help us make a decision,” she said. “A test without some sort of actionable item on the other end is not a useful one.”

Detractors and cheerleaders have voiced their views about Biden's plan. Critics have gone as far as saying it won't work because it's coming from the same administration that brought us Obamacare. That's ridiculous. Cancer is not and should not be a political hot potato.

Sure, there are hurdles to overcome. But government, scientists, hospitals and tech companies should coordinate this effort and move it forward.

Luis Fábregas is the Tribune-Review's medical editor. Reach him at 412-320-7998 or lfabregas@tribweb.com.

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